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Surgical Considerations and Long Term Evaluation

Greenberg, Burt M., MD*; Schneider, Steven J., MD

Journal of Craniofacial Surgery: May 2006 - Volume 17 - Issue 3 - p 528-535
Original Articles

Trigonocephaly accounts for approximately 10% of all craniosynostosis. Severe trigonocephaly results in a triangular-shaped forehead, superior-lateral orbital depression, hypotelorism, and compensatory occipital-parietal calvarial changes. Radiographic findings include ovoid orbits with parallel medial borders, thickened keel-shaped frontal bone, small ethmoid sinuses, and a short anterior cranial fossa with pitched sphenoid wings. Our experience with 50 infantile cases of severe nonsyndromic trigonocephaly patients treated from 1987 to 2005 is clinically reviewed to assess long-term growth based on a standardized operative technique. The average age of the patients at surgery was 6 months and the mean follow-up was 12 years. Our complication rate was 2%; the reoperative rate was 12%. The use of resorbable rigid plate fixation combined with alloplastic augmentation has improved the cosmetic outcome in patients treated since 1996 and reduced the reoperative rate.

From the *Division of Plastic and Reconstructive Surgery, Department of Surgery, Division of Pediatric Surgery, Einstein Medical Center, and Winthrop University Hospital, North Shore University Hospital-Long Island Jewish Health Care System, Manhasset, New York; and Department of Neurosurgery, New York University Medical Center, New York, New York, and North Shore University Hospital-Long Island Jewish Medical Center, New Hyde Park, New York.

New York, New York, USA

Address correspondence and reprint requests to Burt Greenberg, MD, 833 Northern Blvd #230, Great Neck, NY 11021; E-mail:

© 2006 by Mutaz B. Habal, MD.